Yesterday it was confirmed that Starbucks will be extending its No Smoking Policy to within 25 feet of its locations, including locations where there is outdoor seating. As expected, news and social media has been in a tizzy about it. Talks, tweets, and comments have been laced with accusations of Nazi enforcement and fascism. Wow, heavy! Tobacco-Free California must be rejoicing, though.

I was raised in a home where my mother spent many years trying to convince my father to stop smoking. They were married in 1957. By 1967, she had just about had it. She had banned smoking in the food business she had opened with her sister, both at the storefront and in the processing areas. She was determined to ban it completely in our home. My father never smoked in any of the bedrooms. He smoked mostly in the patio. It wasn’t until she enjoined us kids so we could all plead the case for quitting that he acquiesced. And so, for the next 3 years, he tried. Then failed. Then tried again. By 1970, he had completely rid himself of the vice. (Yes, my mother is way ahead of her time, in more ways than this.)

Electronic Cigarette Inhalation (Photo credit: planetc1)

When I was a pediatric resident in Toronto, I had admitted a seven-year old girl in our emergency room late at night. She was brought in by ambulance. She was clearly in severe respiratory distress. She was admitted to the intensive care after we stabilized her. Here was a pretty young girl of Caribbean origin, a clear asthmatic, who was having a severe attack. I later found out her mother was a chain-smoker. The ICU staff called the child protection services (they were called Children’s Aid Society or CAS) to get involved.

Almost a year went by and it was my turn to do my intensive care rotation. On my first night on-call, I had the unfortunate experience of admitting this little girl again! This time she came in intubated. This was her second ICU admission in less than a year. We all knew this did not bode well for her asthma. CAS was involved the entire time. They managed to get a court order to move the child out of her mother’s care until her mother could make the decision to stop smoking in their apartment, clean the place up, and pay attention to the needs of this child sensibly. This is because after her last hospital stay, she was sent to a rehabilitation center for a month where she had not a single episode of wheezing. It was a smoke-free environment obviously.

Last week, I listened to KQED’s Forum with Michael Krasny, discuss the latest California State Senate bill that would regulate electronic cigarettes just like all the other regular tobacco products. Proponents argue that these don’t contain tobacco but only nicotine that is vaporized in the device. Therefore, there is no second-hand smoke. However, there is second-hand vapor! People have complained of eye, nose and throat irritation from the vapors.

Another argument in favor is that it is a “safer alternative” to real tobacco. Really? Does reducing the nicotine to a lower level make it more acceptable and erase the health risk to susceptible individuals and the general public from the exposure, whether they want it or not? I believe that until we are shown just where the exact thresholds are for safety from the toxic, mutagenic, and carcinogenic effects of such substances, we cannot really afford to say when a little is not already too much. What about the nicotine that gets to a smoker’s hair, skin, clothes, or the walls, carpet, curtains, and other fixtures in such public places like restaurants and theaters? We all know what it’s like to enter a hotel room that has been previously occupied by a smoker. All the substances left behind long after the smoker has left, will continue to emit the toxic chemicals absorbed from the smoke. Or even the vapor. Why do the rest of us have to inhale it?

In the discussion, there was also talk of the tobacco companies jumping into the game of the e-cigarettes, as they are called. I’m sure there will be fierce lobbying in favor of blocking any bans and restrictions in a lot of places again. However, places like France, Canada, Australia, Mexico, and Israel, have banned e-cigarettes in non-smoking areas. Is the United States going to stick its head in the mud over this?

A good friend of mine told me she visited her sister and her ailing mother in Texas last week. One morning, they were at a Starbucks near where her mother lived. She and her mother were enjoying their coffee outside when a man came out with his coffee, sat next to their table, and proceeded to light up. This, in spite of the very obvious oxygen tank that sat right next to my friend’s mother and the oxygen tube up her nose. Needless to say, they had to up and leave. And so, yesterday, when news about Starbucks’ commitment to a smoke-free environment was announced, my friend was relieved.

There are a few things that elicit a visceral reaction from me. The entire issue, argument, folly of smoking is one of them. I get totally incensed at the rantings of many hardline smoke-addled brains who can’t see beyond their fix, their rituals, their myopic self-absorbed preoccupation. In the meantime, everyone else around them has to endure the second-hand smoke (or vapor!), the long-term cumulative toll on various organs, most notably the lungs and the heart. Tobacco company sponsored false studies have tried to convince the public otherwise with too many lies. Guys, it culminates in the slow dance of suffocation. How can you not see this?

Will there be push-back for Starbucks? I’m sure there will be. But,

THANK YOU, THANK YOU, THANK YOU, STARBUCKS!

You stood up for equality when you challenged your shareholders about your acceptance of LGBT in your organization. Now, you have upped the ante again over a very important issue!

Kudos to Starbucks. Unfortunately the tobacco lobby is a strong one, which will put any hinders in the way of banning anything they can make money out of. So it’s of no surprise that they are lobbying against any restrictions on e-cigarettes. Money over ethics – as always.

I believe it takes two to tango. The little girl’s home was not the best environment for her. Her mother was going through a lot of turmoil in her life. She was being cared for mostly by her maternal grandmother. Unfortunately, things deteriorated after the grandmother passed away about a year before the multiple visits to the emergency room and the ICU. The grandmother was strict about the sanitation of the home and prohibiting smoking and all sorts of similar activities inside the apartment. With her death, this mother has had to grapple with caring for a young child who has very reactive airways. She had to learn the hard way that irresponsible behavior can put the life of someone at high risk of death.

I’m waiting for the time when smoking will be completely banned from all public places. That may affect my line of work, but even if cigarettes are wiped out from all the earth tomorrow, we will still be seeing its residual ill effects for the next 20 years or more.

Thanks for this very informative post! Here in Australia smoking is prohibited in all inside public places and extends to a lot of outside places as well. I’d like to know why do people get addicted? Cigarettes are enormously expensive in Australia. How can kids or low income adults possibly afford them?

Sounds like Australia has their priorities straight when it comes to tobacco. People get addicted to tobacco, because the substances in tobacco are addicting. There are also some individuals who are prone to getting addicted, more than others. These two factors colliding are a boon to big business. They prey on people’s weaknesses and they develop more addictive versions of the older kinds. Here in America, we have smokers who even dare to spread false information singing praises for tobacco. We have a strange society.

I do not understand the attitude of big business. Why can’t they invest their money in something that’s beneficial? Aim at selling something that people like and makes them feel good. Sell food or drinks that looks and tastes good without having adverse health effects. Is this so difficult?

Thanks for sharing this! I grew up in the 50″s and both of my parents were heavy smokers. They eventually stopped but not until I was in my teens. I remember when airplanes were full of smoke.
Do you ? It was so bad. I am totally anti smoking. YAY Starbucks!!

Very informative, the hospital where I work is committed on being tobacco free hospital. One time in our ICU…. I saw a COPD patient who pulled out an e-cigarette from her purse and smoked through it. I was confused on how I should react to that. I know it’s smoke free but I also knew that she is still getting the nicotine that temporarily paralyze her respiratory celia, often when you give these patients some health info about smoking they get annoyed and will even give back a sarcastic reply. Baffled I left her carrying out her vice…. Now that I know the second hand vapor emitted by e-cigarette then I could at least speak out against smoking again whether it be an e-cigarette.

There’s growing information about electronic cigarettes now. Unfortunately, big business preys on the weaknesses of people. They considered marketing these e-cigarettes as smoking cessation devices but they changed their minds. They found out that smoking cessation devices like nicotine patches, gum, etc. are FDA regulated. So, they marketed these as alternatives. But, even if it’s odorless and smokeless, it still emits the chemicals through the vapor it produces. The chemicals still are toxic and carcinogenic. They also cling to clothes, skin, hair, carpet, curtains, carpets, walls, everywhere. Just because we can’t see or smell it does not mean it’s not harmful. Just like carbon monoxide!